Medical Students as Contributors in Community Practices: A Focus Group Analysis

Background: Community preceptors play an important role in medical education. However, the intrinsic rewards of teaching may no longer outweigh the challenges of training students in the community setting. One potential remedy to increase preceptor retention is to increase medical student contribution in community practices. Objective: To gather medical student opinion and suggestions on innovative ways that medical students can contribute to community practices while still maximizing their learning during clinical clerkships. Methods: I conducted four focus groups with a total of 28 medical students at the University of North Carolina School of Medicine: two groups comprised of preclinical medical students and two groups comprised of clinical medical students. I audiotaped and transcribed all four focus groups. I performed content analysis of the transcripts by hand using the Classic Analysis Strategy as previously described by Krueger and Casey. Findings: Medical students support efforts to have students as contributors to community practices. They strongly favor contributions that involve active roles in patient care or skills training to prepare them for residency. Several potential benefits to community practices include more efficient use of clinical time, greater clinical productivity, and improved quality of care. However, medical students are unconvinced that these new roles will be effectively incorporated into individual community practices. The wide variability in practice styles and infrastructure is seen as an immense barrier to implementing this initiative. Interestingly, medical students suggest that schools hire a practice consultant who can curate a list of best practices and offer strategies for practices to better incorporate medical students into their routine. Conclusion: Medical students see the potential benefits of contributory roles, but are generally apprehensive about the implementation of such roles in community practices. To effectively balance student contribution and student learning, educators must develop clear educational goals, set appropriate expectations among students, and offer faculty development to preceptors. Looking ahead, investigators must acquire the preceptor's perspective on this initiative. In turn, educators can craft favorable pilot programs by accounting for the needs and concerns of both medical students and community preceptors.Master of Public Healt